What Is Centrilobular Emphysema and How Is It Treated

What Is Centrilobular Emphysema?

Centrally located lung disease (CLL) is a rare but potentially fatal disorder characterized by progressive enlargement of the pulmonary arteries and veins. The condition occurs when one or both of these blood vessels become enlarged due to scarring, inflammation, or other causes. These conditions are known as central precordial lesions (CPL). CPL are not usually life threatening, but they may cause significant disability if left untreated.

The most common type of CLL is panlobular emphysema. Panlobulmonary emphysema (PLE), which is the second most common form of CLL, results from abnormal growth of air sacs within the lungs called alveoli. These air sacs contain fluid and produce carbon dioxide gas when they expand during breathing. Panlobulmonary emphysema is often associated with chronic obstructive pulmonary disease (COPD) and smoking.

Other risk factors include age over 60 years, exposure to asbestos, certain drugs such as corticosteroids, and alcohol consumption.

The incidence of panlobular emphysema increases significantly among those who smoke cigarettes. Cigarette smokers have higher rates of PLE than nonsmokers. In the mid-20th century, numerous studies found that cigarette smoke can produce emphysema in laboratory animals. However, the relationship between smoking and CLL in humans has been less clear, with some studies reporting a strong link and others no connection at all.

Panlobular emphysema is mainly a disease of the elderly, especially those who are also smokers. It is rare in people younger than 40 years old. It typically begins in one lung and then, over a period of years, the disease progresses to involve both lungs. PLE may also be a part of a more generalized condition called idiopathic pulmonary fibrosis (IPF), which involves scarring of the lungs.

New approaches to treating CLL may help people with PLE improve their quality of life and prevent or slow down the decline that is typical of this disease. In some cases, the buildup of fluid in the lungs can be drained with a needle, a procedure called pleurodesis. This helps people to breathe more easily and may also improve their quality of life in other ways. Although pleurodesis does not change the long-term outlook for people with PLE, it can help them to feel better and may enable them to participate in rehabilitation programs that could delay the decline caused by the disease.

Sources & references used in this article:

Unraveling the pathophysiology of the asthma-COPD overlap syndrome: unsuspected mild centrilobular emphysema is responsible for loss of lung elastic recoil in … by AF Gelb, A Yamamoto, EK Verbeken, JA Nadel – Chest, 2015 – Elsevier

Centrilobular emphysema experimentally induced by cadmium chloride aerosol by GL Snider, JA Hayes, AL Korthy… – American Review of …, 1973 – atsjournals.org

Abnormal mouse lung alveolarization caused by Smad3 deficiency is a developmental antecedent of centrilobular emphysema by H Chen, J Sun, S Buckley, C Chen… – … of Physiology-Lung …, 2005 – journals.physiology.org